Associations of Lipid Metabolism Abnormalities and Obesity With Endometriosis‐Associated Ovarian Cancer

AIM: To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associated Type I ovarian cancers. METHODS: This retrospective study included 133 patients who underwent surgery for OEC (n = 50) or OCCC (n = 83) between 2010 and 2022. Preoperative serum lipid markers (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and body mass index (BMI) were compared between the two groups. Associations with menopausal status and disease stage were examined, and independent predictors were evaluated by multivariate logistic regression. RESULTS: , p = 0.020) compared with those with OCCC. No significant differences were observed for HDL-C. In premenopausal women, TC and LDL-C were significantly higher in patients with OEC, whereas no intergroup differences were found in postmenopausal women. Among patients with OEC, those with advanced-stage disease had higher TC and LDL-C, whereas no stage-related differences were observed in patients with OCCC. Multivariate analysis identified BMI and LDL-C as independent factors associated with OEC. CONCLUSION: Lipid metabolism abnormalities and obesity were more strongly associated with OEC than with OCCC, suggesting subtype-specific metabolic mechanisms of carcinogenesis and progression. These findings highlight the importance of metabolic factors in OEC, warranting further prospective studies.